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Day 0 (continued) Someone: "Wake up. Can you take a deep breath for me, please?" Me: "Sure.
Can I go back to sleep then?" Someone: "No, you have to wake up. Just take a deep
breath, please."
Just to get rid of this annoyance, I take a deep breath, and then take a couple of
deep coughs to go with it. This causes me to open my eyes, which was evidently the
plot in the first place. I see that the person who has been talking to me is the
recovery room nurse I had talked to before going into the O.R. Coughing AND opening my eyes
is enough exertion for me, so I close my eyes, and doze off again.
Nurse: "Do you want a drink of water?" Me: "No. I'm fine. Can I go back to sleep now?"
Nurse: "No, you need to take just a sip of water." Me: "OK, OK."
As soon as I suck a little water up the conveniently placed straw, I realize that
I'm very thirsty. I take several big swallows of water and go back to sleep.
Nurse: "We need you to move over to this chair and sit up. Can you sit up, please?"
Me: "Sure, but I don't want to. Can I go back to sleep now?" Nurse: "No, you have
to wake up and move to this chair."
I crack open one eye and glance at the chair next to the bed. It's a recliner. Good,
I can sleep in a recliner. If it will get her to go away, I'll move. I do so, and
promptly close my eyes and go back to sleep.
Nurse: "Can you get up and go put your clothes on, please?" I figure that since she
has ignored my other negative answers, she won't listen if I refuse again, so I start
to open my eyes again and grunt something that might pass for an acknowledgment.
She evidently understands this dialect because she hands me the bags containing my clothes
and shoes and points to a door about ten feet away. I am now awake enough to realize
that it is very hard to keep my eyes open and that I have something wrapped around
my head. My wife beams herself in (at my level of awareness, she might well have used
a transporter) next to the chair, and puts my wedding ring back on my finger. OK,
I'm dressed. But, she then forces me to get up and helps me stagger to the restroom/dressing
room door with my bags. I refuse her offer of help in getting dressed because I
know that I'm all grown up now and can do it by myself. Barely. I have to take a
couple of breaks, and sit down on the toilet to keep from fainting, but I finally
manage to get the gown off and my clothes back on. I also manage to get most of my shirt buttons
buttoned (I think) but I end up asking my wife to put my shoes on my feet and tie
them. My head is too heavy to bend over. Before I leave the restroom I find out why,
as I get a glance at myself in the mirror. I have a big bandage on my head that looks
like a beige turban. It comes down far enough to cover my eyebrows. I also have bloody
stitches across both my upper eyelids, a small bruise under my left eye, a swollen
nose and cheeks, and what looks like a coat of grease on my entire face. The car-crash-victim
look is definitely a new one for me.
I exit the restroom, mostly dressed, and return the charming, backless nightie, they
let me model in the operating room. While doing that, I look at the clock on the
wall and see that it is now 3:30 P.M.about 5 hours since I was rolled into the operating
room. As a wheelchair just sort of materializes, I realize that I'm still fairly out
of it. I'm smart enough, though, to sit down in the wheelchair without being told
to do so, and then I take a short nap while someone wheels me to the car. I wake
up long enough to get in the car and put on my seat belt, and then it's lights out again.
I assume my wife drives me home, because the next thing I know, she's helping me
out of the car and into our house. We go into the downstairs bedroom, and I collapse
on the bed. We had decided beforehand that I would sleep in this room, away from the other
bedrooms, for the first night so as not to upset my son with my appearance, and then
to reevaluate based on how bad I looked after that. She sets up some pillows, so
I can sleep in the required upright position, gets me situated on them, takes off my shoes,
and I'm off to dreamland again. I wake up again long enough to realize that she is
putting an ice pack on my facevery nice. Over some course of time, she comes in
periodically to give me drugsvery, very niceand to reapply a new ice pack. I don't know
if she's using bags of frozen peas or not, but they feel good on my eyes. Since sleeping
is one of my favorite recreational activities, I'm having a fairly good time so far.
Day 1:
Bing! I'm awake! It's 3:00 A.M. and suddenly I'm wide awake, ravenous, and thirsty.
Hell, I haven't eaten in over 24 hours, and all I've had to drink is one glass of
water! It's a wonder I haven't wasted away. I get out of bed and shuffle in to the
kitchen, where I drink a big glass of water, a glass of iced tea, and then eat about a pint
of ice cream straight from the carton. I'm topping it all off with a handful of oatmeal
cookies (for fiber) when my wife wanders in and tells me that it's time for my drugs and a new ice pack. I readily comply, as I finish my cookies, and head back to
bed. I realize that I still have my clothes on, so I take them off before lying down
this time. It takes me a while to fall asleep sitting up, now that most of the anesthesia has worn off, but I manage to do it after a hard, five minute struggle. I figure
if I'm going to have to do it this way for a week, I might as well get used to it.
I wake up again about four hours later in a lot of pain. My head hurts, my ears really
hurt where the turban/bandage is squashing them against my head, and my face burns,
itches, stings, and aches all at once. My eyes feel funny, but don't actually hurt
at all. However, I need drugs! Thankfully, my surgeon knew I would, and the pain medication
is right at hand. I take one and half an hour later, I feel much better. For most
of the next week, I will be living my life in these four hour increments in between
the drug dosages. I nap until the afternoon when a nurse comes to the house from the
surgeon's office and removes the bandage. There is also a drain in the top of my
head which she removes. She tells me that instead of a "light peel around my eyes",
the doctor went ahead and did my whole face. I find out later that the doctor referred to
it as "an aggressive peel," not a light one. Just having the elastic turban off makes
my head stop hurting so badly. My hair is absolutely stiff with dried blood, which
I gently wash out as soon as I get the nurse out the door, and get myself into the shower.
I wash very gently because there seems to be an inordinate amount of hardware in
my head.
After my shower, and now that the bandage is off, I check out my face in the mirror
for the first time. I have about a dozen staples all around my face just inside my
hair line and two screws in the top of my forehead. None of these hurt unless I touch
them, so I refrain from playing with the hardware. Because of the swelling, my nose is
now the same width from top to bottom and my cheekbones have disappeared. The stitches
in my eyelids look inflamed but no longer bloody, the bruise under my left eye is
semi-circular, and now about 1 inch long and 1/4 inch wide, and the skin on my face looks
like it has been lightly toasted. It feels that way, too. My lips feel like they
have scales on them, and my eyes feel very dry, and don't seem to be working very
well. The peel was evidently done on my lips, too, and my tear ducts haven't fully recovered
from the surgery. With all the steel and stitches in my face, it's another new look:
Frankenstein. I move upstairs into my own bed, and we finally let my son see me,
telling him that I have "a big owie" on my face. Being the great kid that he is, he takes
that in stride and is very solicitous of me for the next couple of days. I nap frequently
throughout the day and evening, waking up periodically to eat a little something, drink copious amounts of fluid, void copious amounts of fluid, put eye drops in
my eyes, put cortisone ointment on my face and lips, put ice packs on my face, and
of course, take drugs.
Day 2:
I sleep a lot, still waking up at about four hour intervals as the drugs wear off.
My appetite is back to normal, and I get out of bed long enough to eat with the rest
of the family. The bruise under my eye is very noticeable today. I feel like I'm
slightly chilled all day, and I just feel weak and puny. Not a very good day.
Day 3:
This is pretty much a repeat of the previous day, except that I actually feel a little
stronger, and a little better. I take another shower, and I want to stay awake more.
However, since I can't wear my glasses because of my swollen nose, I can't read,
and I refuse to watch daytime television. So, I end up just napping some more. I can't
sleep through the night because of the upright position I have to sleep in, so it's
probably just as well. My wife says that she's not sleeping very well either, because
sitting up to sleep evidently makes me snoreworse. The skin on my face now looks like
I have a very, VERY bad sunburn. It hurts and itches even moreso much so that it
actually keeps waking me up. It's either that, or my snoring. It is very hard to
keep from rubbing or scratching my face. I'm using up a lot of ointment, although the ice
packs help, too.
Day 4:
This day is a step backward. I feel out of sorts, and kind of blah, with no energy.
The good news is that the swelling is starting to go down. My nose is almost normal
size, and my cheeks no longer have that charming chipmunk look. The bruise has at
least stopped deepening its color, halting at a very becoming shade somewhere between aubergine
and claret. The bad news is that my face has started to fall off. Now I know why
they call it a "peel". I'm leaving a trail of my epithelium all over the house. I'm
mixing the ointment with Vaseline now to make it last longer, because it is obvious,
at the rate I'm going, I'm going to run out of ointment before I run out of skin.
It still itches and burns all at once, and my lips still feel scaly. I'm glad I didn't
pay for this abuse.
I leave the house to pick my wife up after she drops her car off at the garage for
some repairs, and I find that I am not really prepared to be driving. I suddenly
have all of my peripheral vision back, after many years of its slowly diminishing,
and it takes me a while to deal with a lot of new sensory input from a much broader field of
vision. In addition, I no longer have a convenient built-in eye shade, in the form
of my upper eyelids, so things are a lot brighter than I'm used to. It's almost a
visual overload, and I find myself driving very carefully and slowly. She drives us home.
Day 5:
A much better day. I actually feel almost normal. At least as normal as one can feel
when their face is coming off in large sheets, and they are carrying enough hardware
in their head to set off the airport metal detector. Almost all of the swelling is
gone, the bruise is fading, and the stitches in my eyelids just look like black marks
on a bright red line. I have started wearing my glasses for an hour or so, just to
read. I'm still taking pain killers, but not as often. I'm still not sleeping all
the way through the night, and I'm still napping for extended periods. I've quit using the
ice packs, since they no longer are needed for the swelling and they don't seem to
be helping with my skin any more. My eyes still don't feel right, and I sometimes
see double in my right eye, although I'm waiting until the stitches come out before I pass
judgment on anything. I also finally shave my face today because I just can't stand
it a day longer. While my beard does not even remotely qualify as heavy, it does
still grow in places. Unfortunately, some of those places are through my poor abused skin,
so I have put off shaving until now. But by going slowly and using a new blade and
moisturizer instead of shave cream, I get the job done.
Day 6:
The stitches have come out of my eyelids, and the staples out my scalp. Removing
the stitches hurt like hell because of the sensitivity of my eyelids, but the pain
didn't last long. Only the removal of one of the staples caused me any pain, and
that was just momentary. The screws will stay in place for another week. They are holding my
forehead up right now and it needs a little longer to set down its new roots. The
skin on my face has all come off at least once, but the area around my mouth and
alongside my nose is still peeling and itching. More cortisone and Vaseline. I feel good enough
to go out to eat, but my wife gently informs me that I'm not really fit to be seen
in public yet.
Day 7:
Back to work, but only for half a day. I get tired too quickly to last for the full
eight hours. I'm wearing my glasses all day and have quit taking the prescription
pain killers. The area around my mouth is still peeling, and is red and sore, but
not unbearably so. I still need to use eye drops once or twice a day to keep my eyes from
drying out. One of the reasons my eyes feel strange is that I have had to learn how
to close my eyes again. Instead of just relaxing and letting gravity drag my old
eyelids down, I now have to really think about closing my eyes because there's not enough
eyelid mass to slam shut under it's own weight. I'm a quick study though, so it's
not a problem for very long. There are some areas of my scalp and my forehead that
are numb, but the surgeon says that it is likely that those areas will recover sensation over
the next year or so. I sleep lying down for the first time in a week, and it feels
a little strange on my face, but I do sleep all the way through the night.
Day 8:
Half day at work again. No significant changes. Although I feel pretty good in the
morning, I still have no real stamina. The skin on my face is slowly healing, but
it seems that the emphasis is on "slowly". My lips still feel like they are extremely
chapped, and nothing I put on them seems to help. People at work have stopped staring
at my red and scaly face and are now staring only at the screws in my head. I guess
that's an improvement.
Day 9-10:
We go out to the movies over the weekend, and I apply the same philosophy to this
outing that I do to passing when dressed en femme: because I don't hear gasps of
horror, or see people laughing and pointing, I assume I must be looking OK. I'm still
putting goop on my lips and my face, though, so I know I'm too shiny.
Day 11:
Back to work for a full day. No other real changes that I can feel, although the
bruise under my eye is rapidly fading.
Day 12:
The screws are out of my forehead, removed with a plain-old-standard sterile screwdriver.
One of the screw holes bled, but there really wasn't any pain involved. The screws
were a lot longer than I had thought. I guess they need the longer ones for the soft, but thick skulls, like mine. It turns out that there were 2 more staples behind
the screws, too, which the surgeon also removed. I'm free of the hardware, although
the doctor tells me not to get too excited just yet. I still cannot fly anywhere,
or exercise for another 3 weeks. I ask him why he did an aggressive, full face peel rather
than the originally proposed light peel around my eyes. His reply is that after the
surgery, he could tell that I was going to look so much better that he figured I
was going to need better looking skin everywhere to match my new look, not just around my
eyes. I resist the temptation to thank him for the free pain, or to call him a flatterer.
The bright red area around my mouth is fading, the bruise under my eye is almost
gone, the eyelid incisions are just red lines, and all the swelling seems to be gone
entirely. I look pretty good, but definitely haven't completed healing yet. I still
feel rather fragile. There's a spot on the top of my head where some fluid and air
had gotten trapped under my scalp during the surgery, and it squishes when I push on it.
The doctor tells me that it will eventually be absorbed, and to not play with it.
As if! It sounds totally icky when pressed, so if I touch it, it's an accident.
Day 13:
Not much difference, with the exception of my lips. This morning, they suddenly feel
better. There is a line along the outer margin of both lips that still feels like
it's numb or callused, but mostly they feel a lot more like normal. I have two little
knots on my forehead where the screws were, but those should heal up in time. When my
eyes get tired, I still have some double vision in my right one, but all in all,
I'm starting to think that I may actually survive this.
Day 14:
I feel good, normal almost, although I'm still having something of a hard time adjusting
to the person in the mirror. The face I see in there is not one of the ones I have
spent almost fifty years getting comfortable with. After two weeks, I'm pretty much all healed upor at least I look healed. I realize that there's a ways to go yet,
but I also know I'll get there, and that it will be worth it when I do. My face is
red, definitely a different color than the rest of my body, but not noticeably so
any more. It continues to slough off, but not in big sheets. Instead, it seems to be coming
off in small granules. It feels rough all the time. Moisturizing really helps, so
I alternate layers of sunscreen and Vaseline during the day, and aloe vera and emu
oil at night. The application of sunscreen to all bare skin above my shoulders will have
to continue for the rest of my life. This is not a big change, though, because I
had been a sunscreen devotee before the operation.
The Next 60 Days:
Gradually healing and looking better day by day. The squishy spot on top of my head
is gone at 19 days. My eyesight is back to some semblance of normal at 20 days, although
I have a minor infection about day 25, which antibiotic eye drops take care of in
a week. My lips are back to normal at 27 days, although they still feel chapped more
often than they used to. My scalp feels normal and firmly reattached at 28 days.
The screw holes are all healed up at 31 days. I start skating again at 34 days. The
eyelid incision lines are no longer really pink and noticeable by 40 days, but they are
still a little tender and painful to the touch until 62 days. My face finally quits
shedding at 42 days, but looks slightly sunburned until 70 days, and even now still
feels almost too tight. The doctor takes his "After" pictures on day 43. I ditch all the
greasy stuff on my face at 48 days when small zits start to show up, but have to
wait until day 60 to start my regular skin care regimen again. Beginning about day
60, I start to have intermittent odd itching sensations and shooting pains in the numb surgical
areas, as the nerves begin to grow back. I take these indicators as a good sign that
I'm still healing OK.
Final Evaluation:
My eyebrows now sit on my brow bone, a good half an inch above their previous location,
and they definitely give my face a more feminine look. As thin as they are, they
actually look almost puny now with so much open space around them.
My forehead is
smooth and wrinkle-free, and I couldn't generate vertical frown lines between my eyes
if I wanted to. The skin just can't wrinkle that way there any more. My eyelids look
very good, my eyes are open, I have a full range of vision, and I don't look tired
all the time. Although the shape of my eyes now is not the shape I have gotten used to over
the years, it's a very nice shape. I've had to relearn how to apply eye makeup that
will look good with my new eyes. The skin on my face is still sensitive, but looks
much better than it did before. Old acne scars, fine lines, and enlarged pores have been
drastically reduced. It's not a porcelain complexion by any definition, but it's
certainly better than I would have ever thought possible for my face. By being smoother,
it also looks more feminine. I've also been told that I look younger now, but I never
really looked my age before the surgery, so I'm not sure how valid that comment is.
The only real down sides to all of this are that my hair line is higher than it used
to be (like I really needed more forehead!), and I still have some numbness in various
spots on my forehead and the top of my head. I know from experience that the numbness
as well as the itching will eventually go away as the damaged nerves heal completely.
The final question everyone asks is, "Was it worth it?," and my answer to that is
mixed. I had no bad reactions to the newer general anesthetic, other than being pretty
zoned out for about 12 hours and feeling a little weak for a couple of days. The
forehead/eyebrow lift and eyelid reduction were definitely worth it. I would recommend that
if someone needed (or wanted) those procedures to go right ahead and have them done.
I had very few complications and excellent results with mine. The facial peel, however, was not worth it in my opinion. Yes, I did see a big improvement in the skin on
my face, but not enough improvement to justify having it done, or its after effects.
Because I got my peel for nothing, I guess I got my money's worth, but unless someone
really, really needed facial skin resurfacing, I would not recommend it. My wife has
suggested that the surgeon did my peel for free to take my mind off the major operations
on my forehead and eyelids. If that was the case, he succeeded, because all I ever
felt was my face, and it felt really bad for almost two weeks.
[For informational purposes, I had an aggressive 40% TCA (trichloroacetic acid) chemical
peel on my entire face, including my lips. "Aggressive" in this context also means
that the TCA was left on longer, and that my face was scrubbed after it was applied. My surgeon said that he opted for that approach instead of a laser peel because he
has had much better results with the TCA peel, in terms of healing time, skin pigmentation
changes, and final results. The cynic in me has noted that the peel was on the doctor's tab, and the TCA is a lot cheaper than the laser.]
Recommendations: 1.
Do an honest self-evaluation of what you want to accomplish with cosmetic or plastic
surgery before you ever visit a doctor. Ask friends and/or family for their honest
opinions, too. 2.
Educate yourself on what is involved with cosmetic surgery in general. There are
numerous books on the subject, but as fast as the field is changing, get one that
was recently written. Or try to find some videos or presentations about i t on TV.
PBS, The Learning Channel, and Discovery Channel all have recently broadcast some cosmetic
surgery operations. 3.
Get recommendations for doctors from friends, family, or other doctors you trust.
The best are from people who have actually undergone the surgery you are contemplating.
Get the names of at least three surgeons and see them all. Try to find doctors who
specialized in plastic surgery AND who list themselves as "Aesthetic" or "Cosmetic"
surgeons. It's also a plus if they are certified in another specialty, like dermatology,
or hold a second degree in dentistry. 4.
Talk frankly to each surgeon about what you want to do and the results you expect.
Listen to what each doctor has to say, too, and be willing to discuss modifying your
expectations. Ask the doctors how many of the proposed operations they have performed
and how often they do them. Ask if the doctor is willing to show you pictures of other
patients and/or give you references you can talk with. 5.
It is very important to choose a doctor that you are comfortable with. If there is
not a rapport between the two of you, or you do not feel at ease with the doctor,
you don't have the right doctor. 6.
Once you have chosen a doctor, follow the directions given to you. The surgeon has
a lot more experience at this than you do, so all the things you are told to do are
for the same reason: better results from your surgery. You have as much to do with
the final outcome of the surgery as your doctor. 7.
Be prepared to be in pain, to be disoriented, to be tired, to be cranky, and to be
just plain miserable for at least a week. Don't try to take care of yourself during
that time. If you live alone and cannot get someone to be a nursemaid for a while,
think about staying in a convalescent facility until you feel better. The operation might
just be on one specific area, but your whole body is involved in recovery and healing.
8.
Finally, be a patient, patient. Be prepared for it to take a long period of time,
even up to several months after you are healed, before you see real results.
If anyone has questions about any aspect of all of this, please feel free to write
me and ask.
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